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Good plan — getting a baseline set of annual blood tests lets you spot trends and catch problems early. What you need exactly depends on your age, sex, family history, meds, symptoms and risk factors, so use this as a starting checklist and review it with your primary care clinician. Below I list core annual tests, useful add‑ons for certain people, practical tips, and a few services/brands you can use.
Core annual blood tests (good for most adults)
- Complete blood count (CBC) — screens for anemia, infection, some blood disorders.
- Comprehensive metabolic panel (CMP) or basic metabolic panel (BMP) — electrolytes, kidney function (creatinine, eGFR), liver enzymes, glucose, and calcium. CMP gives a broader picture (includes liver tests).
- Lipid panel — total cholesterol, LDL, HDL, triglycerides (heart disease risk). Consider fasting vs nonfasting per your provider; many practices use nonfasting now.
- Hemoglobin A1c — average blood sugar over ~3 months (diabetes/prediabetes screening). Often replaced or supplemented by fasting plasma glucose.
- Thyroid-stimulating hormone (TSH) ± free T4 — screens for hypothyroidism or hyperthyroidism. Add free T3 if symptoms suggest hyperthyroidism or lab discordance.
- 25‑hydroxy vitamin D — common deficiency that affects bone, mood, immunity.
- Vitamin B12 (and folate if concerned) — low levels cause fatigue, neuropathy, anemia.
- High-sensitivity C‑reactive protein (hs‑CRP) — general marker of inflammation and cardiovascular risk (optional but helpful if assessing heart risk).
Useful additional tests based on age, sex or risk
- Iron studies (ferritin, iron, TIBC) — if fatigue, heavy menses, or microcytic anemia on CBC.
- Sex-specific hormone tests:
- Men: PSA (prostate-specific antigen) — discuss with your clinician (typically starts 40–50 based on risk), testosterone if symptoms of low T.
- Women: estradiol, FSH/LH only if menopausal symptoms or fertility concerns (not routine annually for all).
- Hepatitis B and C screening — once or periodically if risk factors (IV drug use, blood transfusion before 1992, sexual exposure); baby‑boomers often screened for HCV once.
- HIV test — at least once for adults, more often if ongoing risk.
- Autoimmune or specific disease markers (ANA, rheumatoid factor) — only if symptoms suggest autoimmune disease.
- Advanced lipid tests (apoB, LDL particle number) — if family history of premature CAD or unexplained high risk.
- Fasting insulin or insulin resistance markers — if strong family history of diabetes or metabolic syndrome.
- Ferritin and vitamin tests monitored more frequently if you’re being treated for deficiency or on supplements.
Frequency notes
- Most healthy adults: core set annually.
- More frequent (every 3–6 months) if you have chronic disease (diabetes, liver or kidney disease), are on medications that require monitoring (statins, anticoagulants, thyroid meds), or are correcting a deficiency.
- Some screens (HCV once, HIV at least once) depend on history rather than strict annual schedule.
Practical tips for testing
- Check whether tests require fasting (lipid panel or fasting glucose). If fasting is required, avoid food for 8–12 hours.
- Bring a current medication and supplement list (some affect results).
- Trends matter more than a single value — repeat tests at the same lab if possible for consistency.
- Ask your clinician for interpretation and an action plan if something is out of range.
Where to get tests (brands/services)
- Local primary care + health system labs (e.g., hospital labs, MyChart-linked labs) — best for coordinated care and interpretation with your clinician.
- Quest Diagnostics or Labcorp — nationwide lab networks that accept physician orders and many insurance plans; convenient draw sites.
- Direct-to-consumer/home-test companies if you want convenience or supplemental screening:
- Everlywell and LetsGetChecked — at‑home collection kits for many common tests (convenient; send results online). Good for screening but discuss abnormal results with a clinician.
- HealthLabs or Walk-In Lab — order individual lab panels without a doctor visit in many states.
- InsideTracker or Thorne/WellnessFX — add personalized interpretation and lifestyle recommendations (more expensive, geared toward optimization rather than standard medical screening).
- Concierge/modern primary care (One Medical, Forward) — integrate routine testing with quick access to clinicians and proactive preventive care (useful if you want hands‑on follow-up).
A final note: this is general guidance, not a diagnosis. Before ordering tests on your own, discuss which ones make sense for you with your primary care provider (or pick a reputable DTC service and plan to review abnormal results with a clinician). If you tell me your age, sex, medical history and any symptoms or medications, I can suggest a more tailored annual panel.